MycobacteriumSpecies Related toM. lepraeandM. lepromatosisfrom Cows with Bovine Nodular Thelitis

Pin, Didier; Guérin-Faublée, Véronique; Garreau, Virginie; Breysse, Franck; Dumitrescu, Oana; Lina, Gérard

doi:10.3201/eid2012.140184

Cited by 18 publications

(20 citation statements)

References 13 publications

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“…Recently, leprosy-like dermatitides of animals have been described in cats in Australia (29), red squirrels in Scotland (30), and cows in France (31). Thus far, the etiologic acid-fast bacilli have not been cultivated, similar to the difficulty in cultivation of M. leprae and M. lepromatosis.…”

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confidence: 99%

“…Limited genetic studies of the organisms in cats and squirrels have indicated similarities to the leprosy bacilli (29,30). The study of the cow agent analyzed portions of 6 genes totaling 3,231 nucleotides (31). Judged from the GenBank deposits (KJ095004 to KJ095009), the five protein-coding genes matched 88% to 93% those of M. leprae and/or M. lepromatosis, and the 16S rRNA gene-the most conserved bacterial genematched best with M. lepromatosis (98.4% [361 of 367 bp]).…”

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confidence: 99%

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Diffuse Lepromatous Leprosy Due to Mycobacterium lepromatosis in Quintana Roo, Mexico

Han

Quintanilla

2015

J Clin Microbiol

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A 43-year-old woman of Mayan origin from Quintana Roo, Mexico, was diagnosed with diffuse lepromatous leprosy. The etiologic bacillus was determined to be Mycobacterium lepromatosis instead of Mycobacterium leprae. This case likely represents the first report of this leprosy form and its agent in the southeastern tip of Mexico. CASE REPORTA 43-year-old woman of Mayan ancestry sought dermatologic care in the town of Chetumal, Quintana Roo, Mexico. The patient complained of a 2-year history of burning skin sensation, loss of eyelashes and eyebrows, lower leg edema, and generalized weakness. She was a widowed housewife and had been previously healthy.Physical examination revealed generalized skin infiltration, including areas of prominent "peau d=orange" (erythematous and turgid appearance) and shining skin on the central face, cheeks, and chin. There was extensive loss of hair on arms, legs, and the pubic area. There were no eye lashes or eyebrows. The cornea reflex was diminished. The earlobes were enlarged and indurated. The body skin was dry and did not sweat. There was a generalized loss of sensation to needle pricks over the body. Laboratory examinations showed a normal hemoglobin level (140g/liter), normal counts of blood leukocytes (6.0 ϫ 10 9 / liter) and platelets, a negative VDRL test, a negative human immunodeficiency virus test, and a normal urine test. No thickened nerves were noted. Smears of the nasal mucosa and an earlobe showed acid-fast bacilli with intensities of ϩ and ϩϩ, respectively. These findings led to a working diagnosis of diffuse lepromatous leprosy (DLL) in view of the absence of skin nodules.A skin biopsy of the chin was performed. Histopathology showed extensive infiltration of histiocytes that involved skin appendages and a small nerve (Fig. 1). A Fite stain revealed moderate number of acid-fast bacilli in the skin tissue, with additional locations in the endothelia and a nerve (Fig. 2). These results rendered the diagnosis of DLL.The patient was treated with a multidrug regimen consisting of dapsone, rifampin, and clofazimine. In the third month of treatment, she developed weakness and red nodules on the face and arms, which was consistent with erythema nodosum leprosum. This mild reaction was controlled with 30 mg prednisone daily for 1 week with taper. Upon treatment for 12 months, nasal and earlobe smears remained positive for intact acid-fast bacilli, which led to continued treatment. The patient completed 18 months of treatment, resulting in negative smears and resolution of the skin infiltration and partial recovery of pain sensation, sweating, and hair (in the legs especially). At a 3-year follow-up, she showed nearly complete recovery of sensation and regrowth of hair on her eyelids and eyebrows. Thus, she was considered cured.The diagnosis of DLL prompted a quest to determine the identity of the acid-fast bacillus. Thus, differential PCRs were used to test the DNA extracted from the formalin-fixed paraffin-embedded biopsy tissue. The PCRs targeted the 16S rRNA genes of the...

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Diffuse Lepromatous Leprosy Due to Mycobacterium lepromatosis in Quintana Roo, Mexico

Han

Quintanilla

2015

J Clin Microbiol

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“…Similar mycobacterial dermatitides in cows in France and in cats in Australia have been reported 9 , 10. The study of the cow agent analyzed portions of six conserved genes totaling 3,231 nucleotides 9.…”

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confidence: 61%

“…The study of the cow agent analyzed portions of six conserved genes totaling 3,231 nucleotides 9. Judged from the GenBank deposits (KJ095004–KJ095009), the five protein-coding genes matched 88–93% in sequence with those of M. leprae and/or M. lepromatosis , and the 16S gene matched best with M. lepromatosis (98.4% identity).…”

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Detection of the Leprosy Agent Mycobacterium lepromatosis in South America and Europe

Han

2017

The American Society of Tropical Medicine and Hygiene

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“…Organisms similar to M. leprae and M. lepromatosis have been described very recently in diseased squirrels and bovines (8,9), which raises the possibility of carriers in nature other than the well-known armadillo. In Mexico, where most of the M. lepromatosis cases have been described, it is a custom to eat meat from armadillos and field rats (Rattus rattus) (10).…”

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Mycobacterium lepromatosis Infections in Nuevo León, Mexico

et al. 2015

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The frequency of infection caused by the recently described pathogen Mycobacterium lepromatosis is unknown. Here, we describe the demographics, clinical characteristics, and therapeutic outcomes of five lepromatous leprosy patients suffering from M. lepromatosis infection in Nuevo Léon, Mexico. Diagnosis was facilitated by a new highly specific PCR procedure. Mycobacterium leprae causes Hansen's disease, or leprosy, a chronic infection transmitted from human to human by close contact and manifests clinically in several forms. Leprosy was recently declared to have been eliminated from most regions of the world (1). Since its original description by Armauer Hansen in 1873, the diagnosis of leprosy has relied on the detection of acid-fast bacilli (AFB) in clinical samples. In 2008, a new etiologic agent, Mycobacterium lepromatosis, was associated with leprosy in the United States (2). It was detected in autopsy specimens from two patients of Mexican ethnicity, using molecular biology techniques. On screening samples from patients attending our dermatology clinic who were diagnosed with Hansen's disease, we detected M. lepromatosis in a diffuse lepromatous leprosy (DLL) case (3) but found no evidence for M. leprae in the biopsy sample. Subsequently, cases of M. lepromatosis infection have been reported in Canada, Singapore, Brazil, and Myanmar (4, 5).In Mexico, the largest study conducted was that of Han et al. (6), and this included 120 samples from patients with various clinical forms of leprosy; 63.2% of the cases harbored M. lepromatosis alone, and 16% were mixed infections in which both M. leprae and M. lepromatosis were present. In all these cases, the bacteria were identified using a PCR assay employing primers for the 16S rRNA gene. The genome sequence of M. lepromatosis was recently obtained (7), and loci present in M. lepromatosis, but absent from M. leprae, were identified, thus enabling a highly specific PCR procedure to be established.In the present work, we screened biopsy specimens from patients currently receiving treatment at our clinic to determine the prevalence of M. lepromatosis, or of mixed infections, using a new specific PCR procedure. A diagnosis was initially made clinically and confirmed by the detection of AFB in Fite-Faraco-stained skin biopsy specimens. For molecular analysis, DNA was extracted from the biopsy specimen and used in PCR assays with primers designed to detect M. leprae (RLEP-7 and RLEP-8) or M. lepromatosis (LPM244-F [5=-GTTCCTCCACCGACAAACAC-3=] and LPM244-R [5=-TTCGTGAGGTACCGGTGAAA-3=]) (7). The pair for M. lepromatosis amplifies a 244-bp fragment from the hemN gene missing in M. leprae (7).A total of 38 patients were analyzed; among them, we observed 5 cases positive for M. lepromatosis (Table 1), constituting 13% of the total cases. Four were from Nuevo León and one from the neighboring state of San Luis Potosi, and none were related. Four presented with lepromatous leprosy, of whom three were diagnosed with DLL and one with nodular lepromatous leprosy (NLL); none of t...

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MycobacteriumSpecies Related toM. lepraeandM. lepromatosisfrom Cows with Bovine Nodular Thelitis

Cited by 18 publications

References 13 publications

Diffuse Lepromatous Leprosy Due to Mycobacterium lepromatosis in Quintana Roo, Mexico

Diffuse Lepromatous Leprosy Due to Mycobacterium lepromatosis in Quintana Roo, Mexico

Detection of the Leprosy Agent Mycobacterium lepromatosis in South America and Europe

Mycobacterium lepromatosis Infections in Nuevo León, Mexico

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